Bladder Fullness – Symptoms, Causes, Treatment

Bladder is a small pouch resembling a balloon meant for storing urine produced from the kidneys. Urine gets expelled from the bladder through urethra. Bladder is a small muscular pouch located in the pelvic region and is found above the pubic bone. When it is completely empty, bladder resembles a small pear in size and shape. Two tubing called ureter carries the urine produced from the kidneys to the bladder. Storing and discharging of urine by the bladder can be voluntary or involuntary.

Bladder can store up to 600 ml of urine. When you wish to pass urine, your bladder muscle would contract and opens the two sphincter muscle so that urine flows out. The size of urethra is longer in men than women since it passes through penis.

Bladder can develop many problems like urinary stones, cystitis, overactive bladder and urinary incontinence. It can be painful on the bladder due to infection and inflammation.

Fullness of bladder can be described as a feeling when a person has an urge to urinate. Bladder urging forces an individual to visit the toilet. Bladder fullness can be felt by every person when it gets filled to almost maximum capacity and it gives signal for him to urinate. If the condition does not allow you to visit toilet (attending a meeting or traveling) you can resist the urge only for short time. As time passes, the urge of passing urine gets intensified and the person may end up rushing to the toilet or urinate involuntarily.

The bladder need not be full all the time when a person has a sudden urge to urinate. Bladder fullness can be felt even after passing urine and even small quantity of urine is stoned in the bladder. Under such condition, it can be due to underlying problem.

How Bladder Gets Filled ?

As long as the kidney functions normally, the bladder gets constantly filled with urine, irrespective of time of the day. It depends on factors like how much water and other fluids you consume, levels of hormone and levels of electrolyte. As more and more urine gets filled inside the bladder, the muscles are stretched for accommodating more volumes of urine. Receptors are present in the walls of these muscles which decide the extent to which the muscles can stretch.

Fullness Of Bladder Symptoms :

Some of the symptoms of bladder fullness are as follows :-

Sudden urge to urinate

Burning pain when urinating (dysuria)

Spots of blood seen in the urine

Foul smelling urine (due to infection)

Cloudy urine

More number of visits to the toilet

Passing droplet of urine

Itchy feeling in the genitals

Unable to control urination

Not emptying the bladder completely

Difficulty in starting urination and strain to pass urine

Persistent dribbling

Recurrent urinary tract infections

Bladder Fullness Causes :

Several factors can cause bladder fullness. Abnormal bladder fullness sensation can be felt when the walls of the bladder muscles get irritated. For some people external pressure from the neighborhood organ can cause such feeling. Any problems in the nervous system or spine that controls bladder nerves can cause such problem. Bladder fullness problem is equal in both men and women. The intensity of bladder fullness is high when the bladder already contains about 350 ml of urine and further amount of urine flows into the bladder.

Broadly speaking, fullness of bladder causes can be classified into bladder related problems and non-bladder issues.

Bladder Related Problems :

1. Incomplete Emptying Of Bladder

If the bladder muscles are not contracting properly the bladder may not get emptied fully. Some portion of the urine will be retained in the bladder itself due to inadequate contraction. This can give rise to kidney dysfunction and urinary tract infection, if left untreated.

If there is any obstruction in the urethra sphincter muscles this condition can cause fullness of bladder. In men, urinary retention can occur due to benign prostate hyperplasia.

2. Urethral Obstruction

Urethral obstruction is presence of some blockage in the path of urethra (tube) like kidney stones or excess of calcium crystals. This can directly affect the function of pelvic floor sphincter muscles and this condition is also known as shy bladder syndrome. Self catheterization can be a remedy for such patients.

3. Bladder Dysfunction

Abnormal nervous control of the bladder is technically known as detrusor areflexia. Here the neurological path is either partially or completely obstructed causing abnormal nervous control.

4. Spinal Cord Problem

Any accidental injury of the spine or degenerative disc disorder or some kind of infection in the spinal cord can cause common neurological problem affecting the emptying of bladder. In case of injury of peripheral sacral nerves or cauda equine can severely impair the function of the bladder leading to bladder fullness.

5. Pelvic Surgery

Any individual who has undergone pelvic surgery like abdominal perineal resection or radical hysterectomy can suffer from improper emptying of bladder resulting in bladder fullness. Incidence of cases facing bladder problems is 20-70% in abdominal resection and about 15-80% in case of hysterectomy.

6. Trauma In The Pelvic Muscles

Any trauma, injury or fracture of the pelvic floor bones can affect the normal functioning of bladder. Pelvic fracture is likely to affect the neurological function of bladder resulting in improper emptying of bladder.

7. Herniated Disc

Patients with lumbar disc prolapsed are liable to voiding dysfunction.

8. Myogenic Failure

Smooth muscles of the bladder can get damaged due to detrusor hyporeflexia and over-distension can occur. Temporary myogenic failure can occur after spinal cord injury leading to bladder related problems.

9. Chronic Diabetes

Prolonged diabetes can affect the nerves of bladder particularly the autonomic nerves. The person may no longer feel that the bladder is full due to impaired sensation resulting in voiding of urine.

10. Cystitis

Inflammation or any kind of infection (urethritis) of bladder can affect the bladder function.

Kidney stones (small or large) can obstruct the path of urine resulting in improper function of urinary bladder.

13. Cancer

Any tumor present in the urethra or urinary bladder can affect the normal contracting of bladder.

Non-Bladder Related Problems :

Fecal impaction, presence of tumors in the rectum, and spina bifida and presence of any foreign particles in the bladder or urethra can affect the bladder function.

Bladder Fullness In Men : Benign prostate hypertrophy or enlargement of prostate glands and inflammation of prostate gland can affect the emptying of bladder fully resulting in fullness of bladder.

Bladder Fullness In Women : Problems like cervical tumor, hysterectomy, endometriosis and pregnancy can lead to bladder fullness in women.

Diagnosis :

Based on symptoms and physical examination of the abdomen, your doctor may order for urine culture and blood analysis for detecting any problem. Cystoscopy is a procedure to detect problems in the bladder wherein thin narrow tubing is passed via urethra directly into the bladder. The doctor would attach tiny lighted camera to examine any problem inside the bladder.

Treatment :

Catheterization : For draining the bladder completely, catheterization is effective solution. It can be in the form of urethral catheter or suprapubic catheter. This can be the treatment temporarily but for long-term surgical intervention is necessary. Minor surgery is done for placing a catheter in the end of bladder. Nowadays many patients are taught about the methods of using and cleaning the catheter and this has become the better choice than surgery.

Biofeedback : The patients would learn gradually how to relax and contract the pelvic muscles for passing urine through biofeedback method wherein electrodes are connected to biofeedback machine that sends visual and auditory signals during the contraction of pelvic muscles.

Medications : Urinary retention is treated with prescription medications like bethanechol chloride which can substantially increase the contractibility of bladder muscles facilitating complete emptying of bladder. The drug works within an hour and can be taken on empty stomach.

Botox Injection : A shot of botulinum is given on the pelvic floor for correcting the sphincter spasticity. It is an excellent muscle relaxant making it easy to empty the bladder.